scholarly journals Point-of-care ultrasound diagnosis of flexor tenosynovitis caused by an unusual pathogen

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Margaret C Yates ◽  
Katherine F Chiasson ◽  
Zachary S Pacheco ◽  
John P Gullett ◽  
Brad D Denney ◽  
...  
Keyword(s):  
Immunocompromised Patient ◽  
Point Of Care ◽  
Mycobacterial Infection ◽  
Point Of Care Ultrasound ◽  
Soft Tissue Infections ◽  
Gram Positive Bacteria ◽  
Microbiological Testing ◽  
Nontuberculous Mycobacterial Infection ◽  
History Of ◽  
Flexor Tenosynovitis

ABSTRACT Skin and soft tissue infections are commonly encountered in the emergency department and are typically caused by common gram-positive bacteria. In the immunocompromised patient, however, infections from unusual pathogens should also be considered. We describe the case of a 66-year-old male with a history of renal transplant who was diagnosed with flexor tenosynovitis by point-of-care ultrasound. Although initial wound cultures were negative, subsequent microbiological testing led to the underlying cause, a nontuberculous mycobacterial infection.

Case Report: When all claims that it is necrotizing fasciitis but Point of care ultrasound (POCUS) proves the opposite!

POCUS Journal ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 13-14
Author(s):  
Hadiel Kaiyasah, MD, MRCS (Glasgow), ABHS-GS ◽  
Maryam Al Ali, MBBS
Keyword(s):  
Emergency Department ◽  
Critical Care ◽  
Case Report ◽  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Critical Care Unit ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Soft Tissue Infections

Soft tissue ultrasound (ST-USS) has been shown to be of utmost importance in assessing patients with soft tissue infections in the emergency department or critical care unit. It aids in guiding the management of soft tissue infection based on the sonographic findings.

scholarly journals A History of Fluid Management—From “One Size Fits All” to an Individualized Fluid Therapy in Burn Resuscitation

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 187
Author(s):  
Dorothee Boehm ◽  
Henrik Menke
Keyword(s):  
Fluid Therapy ◽  
Point Of Care ◽  
Fluid Management ◽  
Point Of Care Ultrasound ◽  
Burn Patients ◽  
Starting Point ◽  
History Of ◽  
Definition Of ◽  
Historical Developments ◽  
Burn Resuscitation

Fluid management is a cornerstone in the treatment of burns and, thus, many different formulas were tested for their ability to match the fluid requirements for an adequate resuscitation. Thereof, the Parkland-Baxter formula, first introduced in 1968, is still widely used since then. Though using nearly the same formula to start off, the definition of normovolemia and how to determine the volume status of burn patients has changed dramatically over years. In first instance, the invention of the transpulmonary thermodilution (TTD) enabled an early goal directed fluid therapy with acceptable invasiveness. Furthermore, the introduction of point of care ultrasound (POCUS) has triggered more individualized schemes of fluid therapy. This article explores the historical developments in the field of burn resuscitation, presenting different options to determine the fluid requirements without missing the red flags for hyper- or hypovolemia. Furthermore, the increasing rate of co-morbidities in burn patients calls for a more sophisticated fluid management adjusting the fluid therapy to the actual necessities very closely. Therefore, formulas might be used as a starting point, but further fluid therapy should be adjusted to the actual need of every single patient. Taking the developments in the field of individualized therapies in intensive care in general into account, fluid management in burn resuscitation will also be individualized in the near future.

scholarly journals Cutaneous Nontuberculous Mycobacteria Infection after Cosmetic Tattooing: A Case Report

2020 ◽  
Vol 4 (4) ◽  
pp. 379-382
Author(s):  
Jennifer Seyffert ◽  
Christopher Wong ◽  
Sadia Saeed ◽  
David Fitzmaurice
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Nontuberculous Mycobacteria ◽  
Mycobacterial Infection ◽  
Punch Biopsy ◽  
Soft Tissue Infections ◽  
Papular Eruption ◽  
Nontuberculous Mycobacterial Infection ◽  
Hispanic Male ◽  
Suppurative Inflammation

Nontuberculous (atypical) mycobacteria rarely cause skin and soft tissue infections. Tattooing with contaminated gray ink has been implicated in previously reported outbreaks. We report the case of a 39-year-old Hispanic male who presented with a refractory, pruritic, papular eruption within the distribution of his tattoo with punch biopsy demonstrating papillary dermal granulomatous and suppurative inflammation surrounding small collections of acid-fast bacilli with associated superficial and deep dermal perivascular lymphatic inflammation, consistent with nontuberculous mycobacterial infection. Although uncommon, clinicians should consider nontuberculous mycobacterial infection in the differential diagnosis of refractory tattoo-associated skin eruptions.

scholarly journals Point-of-care Ultrasound in the Diagnosis of Calciphylaxis

2020 ◽  
Vol 4 (3) ◽  
pp. 495-496
Author(s):  
Natasha Tobarran ◽  
Mark Collin
Keyword(s):  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Emergency Physicians ◽  
Computed Tomography Imaging ◽  
Case Presentation ◽  
Tomography Imaging ◽  
History Of ◽  
Calcium Deposits ◽  
Stage Renal Disease ◽  
End Stage

Case Presentation: A 63-year-old male with a past medical history of end stage renal disease presented to the emergency department with painful, lower-extremity necrotic ulcerations. Ultrasound and computed tomography imaging showed concerns for calcium deposits. Biopsy confirmed the diagnosis of calciphylaxis, a rare lethal disease. Discussion: Emergency physicians should keep this disease on their differential due to the high mortality rate.

scholarly journals A Case Report on Paget-Schroetter Syndrome Presenting as Acute Localized Rhabdomyolysis

2020 ◽  
Vol 4 (3) ◽  
pp. 358-361
Author(s):  
Jonathan Lee ◽  
Ami Kurzweil ◽  
Shadi Lahham
Keyword(s):  
Case Report ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Axillary Vein ◽  
Vein Thrombosis ◽  
Chiari Type 1 Malformation ◽  
Arm Swelling ◽  
History Of ◽  
Vein Stenosis ◽  
Deep Vein

Introduction: The life- or limb-threatening differential diagnosis for upper extremity swelling can include deep vein thrombosis (DVT), infectious processes, and compartment syndrome. Chronic anatomic abnormalities such as axillary vein stenosis are rarely a consideration in the emergency department. Case Report: We present a 26-year-old female with history of Chiari type 1 malformation who presented with acute left arm swelling. Initial workup, including point-of-care ultrasound, revealed the presence of significant soft tissue swelling without evidence of DVT. Conclusion: Further workup revealed an early, localized rhabdomyolysis secondary to axillary vein stenosis or venous thoracic outlet syndrome, also known as Paget-Schroetter syndrome.

Case Report: Early signs of tamponade may be detected by cardiac point-of-care ultrasound

POCUS Journal ◽  
2017 ◽  
Vol 2 (3) ◽  
pp. 24-25 ◽  
Author(s):  
Michael Cenkowski, MD ◽  
Amer M. Johri, MD ◽  
Raveen Pal, MD ◽  
Jennifer Hutchison, RDCS
Keyword(s):  
Blood Pressure ◽  
End Stage Renal Disease ◽  
Point Of Care ◽  
Vital Signs ◽  
Point Of Care Ultrasound ◽  
Past Medical History ◽  
Pleuritic Chest Pain ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

A 35-year-old male with a past medical history of end stage renal disease on hemodialysis and a chronic pericardial effusion secondary to dialysis presented to the Emergency Room (ER) with a 2-week history of a flu-like illness and pleuritic chest pain. He was compliant with dialysis three times per week. His blood pressure was 150/85 mmHg with a heart rate of 85 beats per minute and the remainder of his vital signs were stable. Pulsus paradoxus was not present.

Point-of-care ultrasound for diagnosis of purulent flexor tenosynovitis

2021 ◽  
pp. emermed-2020-211113
Author(s):  
Emily Neill ◽  
Nancy Anaya ◽  
Sally Graglia
Keyword(s):  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Flexor Tenosynovitis
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